• Research in Community and Public Health Nursing
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• v.22 no.4
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• pp.377-388
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• 2011

Purpose: This study was to examine the relation between diabetes and cognitive function in older adults. Methods: Eighty community-dwelling patients with diabetes and 506 subjects without diabetes were studied with cognitive function test. Cognitive function was measured by Full-scale IQ, Basic IQ, Executive IQ, Attention Function Index, Working Memory Index, Language Function Index, Visuospatial Function Index, Memory Function Index, and MMSE-K1. Results: In model controlling for education, the diabetic group showed significantly lower scores than the non-diabetic group in in Full-scale IQ (p=.012), Basic IQ (p=.034), Executive IQ (p=.014), Attention Function Index (p=.002), Working Memory Index (p=.037), and Memory Function Index (p=.043). The diabetic and non-diabetic groups that were matched for gender, age, and education showed similar differences in 7 out of 9 cognitive measures. The impairments of Full-scale IQ and Memory Function Index in the diabetic group were, respectively, 2.7 and 2.8 times greater than that in the diabetic group. Conclusion: These results showed that diabetes should be considered to a factor of cognitive impairment in older adults.

• Journal of Nutrition and Health
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• v.42 no.4
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• pp.318-326
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• 2009

We evaluated the vitamin A and E status of type 2 diabetic patients and normal adults living in Daegu area. Dietary intakes for two non-consecutive days were measured by 24-hour recall method for 76 diabetic patients and 72 normal adults. Plasma levels of retinol and ${\alpha}$-tocopherol were measured using HPLC method. Dietary intakes of vitamin A were not significantly different between the diabetic and the normal adults. However, the diabetic patients had significantly lower vitamin E intakes than the normal adults. Major food sources for vitamin A intake were red pepper powder and carrot. Half of the subjects from diabetic as well as normal adults consumed less than estimated average requirement of vitamin A. Plasma levels of retinol and tocopherol were maintained within normal ranges for most of the subjects regardless of diabetic status. Dietary intake of vitamin A was associated with vitamin E intake, however, there was no significant correlations between vitamin E intake and plasma ${\alpha}$-tocopherol levels. It seems that diabetic patients should try to increase dietary intake of vitamin E, as prolonged lower-level intake of vitamin E could eventually lead to vitamin E depletion. Further studies are needed to identify the magnitude of dietary variance at individual and seasonal levels, and to understand the discrepancies in dietary intake and plasma levels before establishing the dietary reference intake based on Korean dietary pattern.

• Nutrition Research and Practice
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• v.13 no.3
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• pp.240-246
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• 2019

BACKGROUND/OBJECTIVES: Diabetes is diagnosed after an average of 10-12 years of diabetic development. Strict glycemic control in diabetic patients promotes the normalization of blood glucose and reduces cardiovascular diseases (CVDs) and diabetic complications. Therefore, early diagnosis in non-aware individuals is very important. SUBJECTS/METHODS: Clinical indices and nutrient intakes in Korean diabetic adults aged 19-64 years were examined according to the awareness of diabetes, using 2012 and 2013 Korea National Health and Nutrition Examination Survey (KNHANES) data. The aware group was defined as individuals who were aware of having diabetes from diagnosis by physician before the survey and the non-aware group as individuals who were not aware of having diabetes. RESULTS: The average age was higher in the aware group compared to the non-aware group in both men (P = 0.002) and women (P = 0.004). The prevalences of hypertension and dyslipidemia were not different between the two groups, but the diagnosis rate was significantly lower in the non-aware group. In the non-aware group, total and LDL-cholesterol were significantly higher (P < 0.001), the risk for total cholesterol over 240 mg/dL was 3.4 times (95% CI: 1.58-7.52) higher (P = 0.002) and the risk for LDL-cholesterol over 160 mg/dL was 4.59 times (95% CI: 2.07-10.17) higher (P < 0.001). The calorie intake of the female non-aware group was significantly higher compared to the female aware group (P = 0.033). CONCLUSION: The results suggested that the recommendation of screening test is necessary even for young adults. Studies on the methodology for early diagnosis of diabetes are also needed.

• Korean Journal of Community Nutrition
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• v.14 no.2
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• pp.229-235
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• 2009

This study was carried out to determine whether a short-term zinc supplementation could improve the zinc status without adverse changes in copper status among type 2 diabetic patients. Seventy-six diabetic subjects and 72 normal adults participated in this study. Subjects were randomly divided into supplemented and control groups. Forty-four diabetic patients and 34 normal subjects were supplemented with 50 mg zinc gluconate daily for 4 weeks. Dietary intakes of participants were measured for two non-consecutive days by 24-hour recall method. Nutritional status of zinc and copper were also evaluated by biochemical measurement of fasting plasma samples and spot urinary collection. At baseline, diabetic patients showed significantly lower levels of dietary zinc intake and higher urinary zinc excretion than the normal adult group(p<0.05, p<0.0001). Plasma level of zinc was not significantly different between diabetic and normal adults at baseline. However, plasma zinc level increased significantly in both diabetic patients and normal adults after zinc supplementation. The changes in plasma copper levels following zinc supplementation were not statistically significant in diabetic subjects as well as in normal adults. These results indicated that four weeks of zinc supplementation did not influence Cu status and that it may contribute to improving the zinc status. Therefore, we suggest that Zn supplementation for a short-term period may improve marginal zinc status of diabetic patients without interfering with their copper status

• Korean Journal of Clinical Laboratory Science
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• v.50 no.2
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• pp.190-196
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• 2018

Obesity has been reported to be a cluster of risk factors in the pathological ecology, In particular, there is increasing evidence that inflammation-related factors are associated with diabetes. This study examined the relationship between the hs-CRP level and FBG, fructosamine, and $HbA_1c$ in 4,734 non-diabetic adults aged 20 years or older, who were approved by the National Health and Nutrition Survey in 2015. The results showed that the FBG, fructosamine, and $HbA_1c$ levels increased with increasing BMI; the hs-CRP levels were the highest in the obese group, and HOMA-IR, an index of insulin resistance, was also significantly higher in the obese group. The hs-CRP level was the highest in obese adults. The levels of FBG, fructosamine. and $HbA_1c$, which are involved in blood glucose control, increased with increasing hs-CRP level. The FBG, fructosamine, and $HbA_1c$ levels increased significantly with increasing hs-CRP level after adjusting for various related variables. These results suggest that the obesity-induced increase in hs-CRP is a risk factor for diabetes mellitus in non-diabetic adults. Therefore, proper dietary habits and regular exercise should prevent diabetes by preventing obesity in non-diabetic adults.

• Journal of Korean society of Dental Hygiene
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• v.16 no.2
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• pp.233-240
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• 2016

Objectives: The aim of this study was to evaluate the oral health status and behavior in Korean diabetic adults. Methods: The study subjects were 11,840 adults who participated in the fifth Korea National Health and Nutrition Examination Survey(2010-2012). Diabetic status was defined by doctors and fasting blood sugar(FBS) level. Oral health status was assessed by decayed-missing-filled teeth(DMFT), community periodontal index(CPI), periodontal disease, denture needs, limitation of oral function, and chewing difficulty. The oral health behavior was evaluated by oral examination within a year, brushing times a day, and use of auxiliary oral product. The data were analyzed by descriptive analysis, chi-square tests and multiple logistic regression analyses. Results: The prevalence rate of diabetes mellitus diagnosed by doctor and FBS was 8.3% and 10.2%, respectively. The prevalence rate of periodontitis was 25.4%. The proportions of $DMFT{\geq}20$, $CPI{\geq}3$, periodontal disease, denture needs, oral function limitation and chewing difficulty in the confirmed diabetic group by doctor were significantly higher than those of the non-diabetic group(p<0.05). In multiple logistic regression analysis, the adjusted odds ratio(aOR) for periodontal disease(aOR=1.73, 95% CI=1.41-2.12), presence of denture needs(aOR=1.40, 95% CI=1.06-1.84), limited oral function(aOR=1.43, 95% CI=1.15-1.78) and chewing difficulty(aOR=1.41 95% CI=1.13-1.77) in diabetic subjects were significantly higher than those of the non-diabetic subjects. There were similar associations between diabetes defined with FBS and oral health. In oral health behavior, diabetic subjects had significantly lower odds ratios for oral examination(aOR=0.76, 95% CI=0.60-0.98), brushing time ${\geq}2$ times(aOR=0.73, 95% CI=0.57-0.93), and auxiliary oral products(aOR=0.74, 95% CI=0.59-0.94). Conclusions: There was a significant relationship between oral health status and behavior in Korean diabetic adults. Further study is needed to evaluate the underlying mechanisms between diabetes mellitus and oral health status.

• Research in Community and Public Health Nursing
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• v.30 no.4
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• pp.560-570
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• 2019

Purpose: The purpose of this study was to examine the effects of diabetic foot care education for the older adults with low health literacy. Methods: A quasi-experimental design with a non-equivalent control group pretest-posttest was used. The participants who were diagnosed with diabetes, were adults over 65 years old at the welfare center of Y and B city. They were divided into the experimental group (n=32) and the control group (n=31). Inclusion criteria were a score of 5 or under on the Short form of Korean Functional Health Literacy Test and 24 or more on the Korean version of Mini-Mental State Examination. Foot care education was conducted in a small group for 40 minutes, once a week, for three weeks. The education materials are composed of an easy term, picture and photographs to understand easily. Results: The scores of diabetic foot care knowledge (t=4.57, p<.001), foot care self-efficacy (t=6.07, p<.001), and foot self-care behavior (t=4.18, p<.001) were significantly increased in the experimental group compared to the control group. Foot health status was not significantly improved. Conclusion: The findings indicate that this education program can be used as a nursing intervention improving foot care knowledge, foot care self-efficacy, and foot self-care behavior in order to prevent the diabetic foot problems of elderly diabetic persons with low health literacy.

• Journal of the Korean Dietetic Association
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• v.23 no.1
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• pp.54-63
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• 2017

Anemia, defined as a reduction in the hemoglobin concentration of blood, is common in diabetes mellitus (DM) patients, can be potentially caused by diabetes complications such as nephropathy. Recent research suggests that diabetes mellitus (DM) itself may be a major risk factor of anemia. However, there are few Korean studies on the relationship between diabetes mellitus (DM) and anemia. This study was performed to investigate the association between anemia and diabetes mellitus (DM) in Korean adults. A total of 10,151 Korean adults over aged 19 years (4,422 male, 5,729 female) were selected from the participants of the Korean National Health and Nutrition Examination Survey VI (KNHANES VI). Korean adults with anemia had a higher prevalence of diabetes mellitus (DM) than the normal adults (11.4% vs. 30.4% in male, 8.8% vs. 9.4% in female). The unadjusted odds ratio (OR) for anemia was greater in adults with DM than in normal male (OR=3.28; 95% CI: 2.27~4.73). After adjusting for other risk factors including age, education, family income, smoking, drinking, and menstrual status, anemia and diabetes were not associated (OR=1.33; 95% CI: 0.84~2.09). Similarly, there was no association between anemia and diabetes in female. In conclusion, this study shows that the prevalence of anemia is similar in diabetic and non-diabetic Korean adults after adjusting for multiple risk factors. Further research is required to elucidate the mechanism of anemia caused as a consequence of diabetes mellitus (DM).

• Journal of the Korea Academia-Industrial cooperation Society
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• v.18 no.6
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• pp.180-186
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• 2017

This study examined the prevalence of an impaired fasting glucose and related factors in normal non-diabetic adults. This study used the raw data (general characteristics, health behavior, obesity, impaired fasting glucose etc.) from the 6th Korea National Health & Nutrition Examination Survey (NHANES) in the second year (2014), and out of all 7,550 survey participants, 1,341 were selected as the final research subjects. After stratifying according to obesity, a logistic regression model was used to analyze the factors related to an impaired fasting glucose level. The older subjects were more likely to have an impaired fasting glucose in both the obesity group and normal weight group (p<.001). The obesity group showed a higher impaired fasting glucose rate when they drank more alcohol (p<.05) and consumed less fruit (p<.05). Therefore, balanced nutrients and control of the blood sugar level through proper education and public health policies of fruit intake and alcohol are needed.

• Journal of Preventive Medicine and Public Health
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• v.45 no.2
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• pp.62-69
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• 2012

Objectives: Chronic inflammation is now thought to play a key pathogenetic role in the associations of obesity with insulin resistance and diabetes. Based on our recent findings on persistent organic pollutants (POPs) including the lack of an association between obesity and either insulin resistance or diabetes prevalence among subjects with very low concentrations of POPs, we hypothesized that POP concentrations may be associated with inflammation and modify the associations between inflammation and insulin resistance in non-diabetic subjects. Methods: Cross-sectional associations among serum POPs, C-reactive protein (CRP), and homeostasis model assessment of insulin resistance (HOMA-IR) were investigated in 748 non-diabetic participants aged ${\geq}20$ years. Nineteen types of POPs in 5 subclasses were selected because the POPs were detectable in ${\geq}60%$ of the participants. Results: Among the five subclasses of POPs, only organochlorine (OC) pesticides showed positive associations with CRP concentrations, while polychlorinated biphenyls (PCBs) showed inverse associations with CRP concentrations. There were statistically significant interactions between CRP and OC pesticides and between CRP and PCBs, in estimating HOMA-IR (P for interaction <0.01 and <0.01, respectively). CRP was not associated with HOMA-IR among subjects with low concentrations of OC pesticides or PCBs, while CRP was strongly associated with HOMA-IR among subjects with high concentrations of these POPs. Conclusions: In the current study, OC pesticides were associated with increased levels of CRP, a marker of inflammation, and both OC pesticides and PCBs may also modify the associations between CRP and insulin resistance.